Bacterial Etiology of Respiratory Tract Infections among Ambulatory School Children in Moshi Municipality, Tanzania
Science Journal of Public Health
Volume 3, Issue 5, September 2015, Pages: 625-632
Received: May 30, 2015;
Accepted: Jun. 11, 2015;
Published: Jul. 1, 2015
Views 4889 Downloads 164
James Samwel Ngocho, Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical University College, Moshi, Tanzania; Kilimanjaro Christian Medical Centre, Duke University Collaboration Clinical Research Site, Moshi, Tanzania
Caroline Amour, Haydom Global Health Institute, Manyara, Tanzania
Margaretha Sariko, Clnical laboratory department, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
Blandina Theophil Mmbaga, Kilimanjaro Christian Medical Centre, Duke University Collaboration Clinical Research Site, Moshi, Tanzania; Department of pediatrics and child health, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
Gibson Sammy Kibiki, Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical University College, Moshi, Tanzania; Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
Background: Respiratory tract infections are the leading cause of morbidity and mortality in children worldwide. Management of respiratory tract infections poses a challenge in developing countries particularly due to limited resources for bacterial identification. The objective of this study was to describe bacterial etiological agents causing respiratory tract infections and their resistance patterns among ambulatory school children in Moshi municipality, Tanzania. Methodology: A cross sectional community based study was conducted, from January to March 2014 in 4 primary schools in Moshi Municipality. All school children available at the time of study were assessed for respiratory symptoms, those with self-reported respiratory tract symptoms for four days or more were eligible for participation. While those on medication and those who completed oral medication within 15 days prior to screening were excluded. Nasopharyngeal and throat swabs were collected from eligible children. Isolates were tested for sensitivity against commonly used antibiotics. Results: Of 2,016 screened school children, 474 (23.5%) had respiratory tract symptoms. Respiratory tract bacterial pathogens were isolated from 123 (73.7%) of 167 children whose nasopharyngeal and throat swabs were collected, three children did no show for swab collection. S. aureus was the most prevalent isolate 68 (55.3%) followed by S. pneumoniae 43 (35.0%), and the least prevalent isolate was K. pneumoniae 7 (5.7%). Majority of isolated upper respiratory tract bacteria were resistant to ampicillin. S. pneumoniae exhibited the highest rate of the resistance whereby, 33 (91.7%) isolates were resistant to ampicillin. However, the resistance of isolates to cotrimoxazole was found to be low. Gentamicin and ceftriaxone were effective against most isolates. Conclusion: Prevalence of respiratory tract symptoms was high among ambulatory school children who were presumed to be healthy. The observed high resistance of isolates might be due to unnecessary prescription of antibiotics, and counterfeit drugs. There is a need to strengthen school health program, in order to identify children with respiratory tract infections and refer them to a health facility for further evaluation.
James Samwel Ngocho,
Blandina Theophil Mmbaga,
Gibson Sammy Kibiki,
Bacterial Etiology of Respiratory Tract Infections among Ambulatory School Children in Moshi Municipality, Tanzania, Science Journal of Public Health.
Vol. 3, No. 5,
2015, pp. 625-632.
WHO. Fact sheet N°331 Reviewed November 2013. 2013;(November).
Mcintosh K. Community - Acquired pneumonia in children. N Engl J Med. 2002;346(6):429–37.
Tsolia MN, Psarras S, Bossios a, Audi H, Paldanius M, Gourgiotis D, et al. Etiology of community-acquired pneumonia in hospitalized school-age children: evidence for high prevalence of viral infections. Clin Infect Dis. 2004 Sep 1;39(5):681–6.
Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bulletin of the World Health Organization. 2008. p. 408–16.
Ei N, Ezute S, Cc EN, Cc O, Eze C. Bacteria etiological agents causing respiratory tract infections in children and their resistance patterns to a panel of ten antibiotics. Asian Pacific J Trop Dis. 2012;18–23.
Boloursaz MR, Lotfian F, Aghahosseini F, Cheraghvandi A, Khalilzadeh S, Farjah A, et al. Epidemiology of Lower Respiratory Tract Infections in Children. J Compr Pediatr. 2013 Mar 2;3(3):93–8.
Bellos A, Mulholland K, Brien KLO, Qazi SA, Gayer M, Checchi F. The burden of acute respiratory infections in crisis-affected populations : a systematic review. Confl Health. 2010;1–12.
Cashat-Cruz M, Morales-Aguirre JJ, Mendoza-Azpiri M. Respiratory tract infections in children in developing countries. Semin Pediatr Infect Dis. 2005 May;16(2):84–92.
Nair H, Simões E a F, Rudan I, Gessner BD, Azziz-Baumgartner E, Zhang JSF, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013 Apr 20;381(9875):1380–90.
Hayward G, Thompson M, Hay AD. What factors influence prognosis in children with acute cough and respiratory tract infection in primary care? BMJ. 2012 Jan;345(September):e6212.
Denny FW. Acute Respiratory Infections in Children: Etiology and Epidemiology. Pediatrics in Review. 1987. p. 135–46.
Carepetis J, Brown A, Maguire G, Walsh W, Noonan S, Thompson D. The Australian guideline for prevention , diagnosis and management of acute rheumatic fever and rheumatic heart disease ( 2nd edition ). Menzies; 2012.
Keith T, Saxena S, Murray J, Sharland M. Risk-benefit analysis of restricting antimicrobial prescribing in children: what do we really know? Curr Opin Infect Dis. 2010 Jun;23(3):242–8.
Gwimile JJ, Shekalaghe SA, Kapanda GN, Kisanga ER. Antibiotic prescribing practice in management of cough and/or diarrhoea in Moshi Municipality, Northern Tanzania: cross-sectional descriptive study. Pan Afr Med J. 2012 Jan;12:103.
Boogaard JVANDEN, Semvua HH, Boeree MJ, Aarnoutse RE. Assessment of antibacterial sale by using the Anatomic Therapeutic Chemical classification and Defined Daily Dose methodology in Moshi Municipality , northern Tanzania. Tanzan J Health Res. 2010;12(3).
Joloba ML, Bajaksouzian S, Palavecino E, Whalen C, Jacobs MR. High prevalence of carriage of antibiotic-resistant Streptococcus pneumoniae in children in Kampala Uganda. Int J Antimicrob Agents. 2001;17:395–400.
Gazi H, Kurutepe S, Sürücüoğlu S, Teker A, Ozbakkaloglŭ B. Antimicrobial susceptibility of bacterial pathogens in the oropharynx of healthy school children in Turkey. Indian J Med Res. 2004 Nov;120(5):489–94.
Jain A, Kumar P, Awasthi S. High nasopharyngeal carriage of drug resistant Streptococcus pneumoniae and Haemophilus influenzae in North Indian schoolchildren. Trop Med Int Health. 2005 Mar;10(3):234–9.
Telmesani AM a, Ghazi HO. A study of group a streptococcal bacteria isolation from children less than 12 years with acute tonsillitis, pharyngitis and healthy primary school children. J Family Community Med. 2002 May;9(2):23–6.
Chandler CIR, Nadjm B, Boniface G, Juma K, Reyburn H, Whitty CJM. Assessment of Children for Acute Respiratory Infections in Hospital Outpatients in Tanzania : What Drives Good Practice ? Am J Trop Med Hyg. 2008;79(6):925–32.
Reyburn H, Mwakasungula E, Chonya S, Mtei F, Bygbjerg I, Poulsen A, et al. Clinical assessment and treatment in paediatric wards in the north-east of the United Republic of Tanzania. Bull World Health Organ. 2008 Feb 1;86(2):123–39.
Berkley J a, Maitland K, Mwangi I, Ngetsa C, Mwarumba S, Lowe BS, et al. Use of clinical syndromes to target antibiotic prescribing in seriously ill children in malaria endemic area: observational study. BMJ. 2005 Apr 30;330(7498):995.
Goel K, Ahmad S, Agarwal G, Goel P, Kumar V. A Cross Sectional Study on Prevalence of Acute Respiratory Infections (ARI) in Under-Five Children of Meerut District, India. J Community Med Health Educ. 2012;02(09):2–5.
Hill PC, Akisanya A, Sankareh K, Cheung YB, Saaka M, Lahai G, et al. Nasopharyngeal carriage of Streptococcus pneumoniae in Gambian villagers. Clin Infect Dis. 2006 Sep 15;43(6):673–9.
Zanelli G, Sansoni A, Zanchi A, Cresti S, Pollini S. Staphylococcus aureus nasal carriage in the community : a survey from central Italy. Epidemiol Infect. 2002;417–20.
Bogaert D, Van Belkum A, Sluijter M, Luijendijk A, De Groot R, Rümke HC, et al. Colonisation by Streptococcus pneumoniae and Staphylococcus aureus in healthy children. Lancet. 2004;363(9424):1871–2.
Pavilonyte Z, Kacerauskiene J, Budryte B, Keizeris T, Junevicius J, Pavilonis A. [Staphylococcus aureus prevalence among preschool- and school-aged pupils]. Medicina (Kaunas). 2007 Jan;43(11):887–94.
Pavilonyt Ž, Kauk R, Antu A, Pavilonis A. KLINIKINIAI TYRIMAI Staphylococcus aureus paplitimas hospitalizavimo laikotarpiu. Medicina (B Aires). 2008;44(8).
Abdullahi O, Nyiro J, Lewa P, Slack M, Scott JAG. The descriptive epidemiology of Streptococcus pneumoniae and Haemophilus influenzae nasopharyngeal carriage in children and adults in Kilifi district, Kenya. Pediatr Infect Dis J. 2008 Jan 15;27(1):59–64.
Nyawawa E, EV U, Chillo P, Waane T, Lugazia E, Mpoki U, et al. Cardiac Surgery : One Year Experience of Cardiac Surgery at Muhimbili National Hospital , Dar es Salaam , Tanzania. East Cent African J Surg. 2010;15(1):111–8.
White A V, Hoy WE, Mccredie DA. Childhood post - streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life chronic renal disease in later life. MJA. 2001;174(10):492–6.
Dumre S, Sapkota K, Adhikari N, Achary D, Karki M, Bista S, et al. Asymptomatic throat carriage rate and antimicrobial resistance pattern of. Kathmandu Univ Med J. 2009;7 No. 4(28):392–6.
Ndoyo J, Siopathis RM, Klugman KP, Wasas A. Antibiotic resistance among nasopharyngeal isolates of Streptococcus pneumoniae and Haemophilus influenzae--Bangui, Central African Republic, 1995. MMWR Morb Mortal Wkly Rep. 1997;46(3):62–4.